-
British Journal of Rheumatology Jan 1997
Comparative Study Review
Topics: Antirheumatic Agents; Arthritis, Rheumatoid; Humans; Penicillamine
PubMed: 9117147
DOI: 10.1093/rheumatology/36.1.104 -
Bailliere's Clinical Rheumatology Dec 1990D-Pen represents an effective treatment for a proportion of patients with RA and PSS. Its status in the treatment of juvenile RA is uncertain. The best results will be... (Review)
Review
D-Pen represents an effective treatment for a proportion of patients with RA and PSS. Its status in the treatment of juvenile RA is uncertain. The best results will be obtained by a skillful, careful physician maintaining careful surveillance for toxicity. Neither the mode of action nor the mechanisms of toxicity are well understood in RA. Consequently, safer and more effective analogues of D-pen have not been produced.
Topics: Arthritis, Juvenile; Arthritis, Rheumatoid; Drug Prescriptions; Humans; Penicillamine; Rheumatic Diseases; Scleroderma, Systemic
PubMed: 2093440
DOI: 10.1016/s0950-3579(05)80007-x -
Journal of the American Academy of... Nov 1996The successful therapeutic use of D-penicillamine (DPA) has been hindered by its many adverse effects. Autoimmune bullous syndromes are among the less common adverse DPA... (Review)
Review
The successful therapeutic use of D-penicillamine (DPA) has been hindered by its many adverse effects. Autoimmune bullous syndromes are among the less common adverse DPA reactions; they are not dose dependent and appear late in the treatment of diseases of altered immunity, most often rheumatoid arthritis. The majority of the DPA-induced bullous syndromes belong to the pemphigus spectrum, usually pemphigus foliaceus or erythematosus, have a lower prevalence of demonstrable tissue-fixed or circulating antibodies than spontaneously occurring pemphigus, display abnormal direct immunofluorescent patterns, and have a generally favorable prognosis. However, many cases do exhibit a full-blown chronic disease, unaffected by DPA withdrawal. DPA-induced cicatricial pemphigoid is a severe disease of both mucous and cutaneous involvement with a prognosis similar to the spontaneous disease. Cases of DPA-induced epidermolysis bullosa acquisita and DPA-induced bullous pemphigoid were not sufficiently substantiated by immunofluorescence or immunoprecipitation criteria.
Topics: Drug Eruptions; Humans; Penicillamine; Skin Diseases, Vesiculobullous
PubMed: 8912569
DOI: 10.1016/s0190-9622(96)90729-x -
Proceedings of the Royal Society of... 1977
Review
Topics: Animals; Chemical Industry; Humans; Lethal Dose 50; Penicillamine; Quality Control
PubMed: 122673
DOI: No ID Found -
Journal of the American Academy of... Apr 1983D-Penicillamine, a heavy metal chelator used in the treatment of Wilson's disease and other conditions, may be associated with both noncutaneous and cutaneous side... (Review)
Review
D-Penicillamine, a heavy metal chelator used in the treatment of Wilson's disease and other conditions, may be associated with both noncutaneous and cutaneous side effects. Some of the cutaneous lesions are due to a toxic-metabolic effect on connective tissue; some may be explained on the basis of autoimmunity; some are acute sensitivity reactions, and some are secondary to unknown mechanisms. The types of cutaneous manifestations may, in some instances, be correlated with the disease being treated and the dosage and duration of penicillamine therapy.
Topics: Autoimmune Diseases; Collagen; Dermatitis, Atopic; Drug Eruptions; Elastin; Humans; Lichen Planus; Penicillamine; Skin; Stomatitis, Aphthous
PubMed: 6222087
DOI: 10.1016/s0190-9622(83)70062-9 -
Proceedings of the Royal Society of... 1977
Review
Topics: Hepatolenticular Degeneration; Humans; Joint Diseases; Penicillamine
PubMed: 122670
DOI: No ID Found -
Scandinavian Journal of Rheumatology.... 1979The use of penicillamine in rheumatoid arthritis (RA) is limited by the incidence of adverse effects, some of which are potentially hazardous. However, adverse effects... (Review)
Review
The use of penicillamine in rheumatoid arthritis (RA) is limited by the incidence of adverse effects, some of which are potentially hazardous. However, adverse effects are dose-related and the advantages and disadvantages of different fixed and flexible dose regimes are discussed. The incidence of adverse effects is significantly greater in patients previously treated with gold who developed toxicity to that drug--no such increase being found in gold treated patients whose only reason for stopping gold was ineffectiveness. Rashes which develop after several months of treatment are variants of pemphigus and their various presentations are described. Fatal reactions, fortunately rare, are predominantly associated with aplasia of the bone marrow. Monthly haematological checks coupled with meticulous charting of the results may reveal trends as well as numerical changes and serve as an early warning of marrow damage.
Topics: Anemia, Aplastic; Anti-Glomerular Basement Membrane Disease; Arthritis, Rheumatoid; Bone Marrow; Drug Eruptions; Hematologic Diseases; Humans; Penicillamine
PubMed: 156393
DOI: 10.3109/03009747909108247 -
The Journal of Rheumatology. Supplement 1981D-penicillamine is rapidly absorbed from the intestine and appears in plasma as free penicillamine, cysteine-penicillamine disulfide, and penicillamine disulfide.... (Review)
Review
D-penicillamine is rapidly absorbed from the intestine and appears in plasma as free penicillamine, cysteine-penicillamine disulfide, and penicillamine disulfide. Penicillamine binds firmly to serum and tissue proteins. The urinary excretion of S-methyl-D-penicillamine, cysteine-penicillamine disulfide, penicillamine disulfide, and a newly identified metabolite, homocysteine-penicillamine disulfide, has been quantitated for patients with rheumatoid arthritis, cystinuria, and Wilson's disease. Fifty percent of an oral dose is excreted in the feces, but the metabolites have not yet been fully characterized. The pharmacologic effects of D-penicillamine are associated with disulfide bond formation or cleavage, thiazolidine formation, and metal chelation.
Topics: Absorption; Arthritis, Rheumatoid; Cystinuria; Hepatolenticular Degeneration; Humans; Penicillamine; Receptors, Drug
PubMed: 7014876
DOI: No ID Found -
British Medical Journal (Clinical... Mar 1981
Topics: Drug Administration Schedule; Humans; Kidney Diseases; Penicillamine; Proteinuria
PubMed: 6783160
DOI: No ID Found -
Revue Du Rhumatisme Et Des Maladies... Jan 1986After reviewing the history of the discovery of the action of D-penicillamine in rheumatoid arthritis, the authors define the practical modalities for the management of... (Review)
Review
After reviewing the history of the discovery of the action of D-penicillamine in rheumatoid arthritis, the authors define the practical modalities for the management of treatment based on their own experience and on the data from the literature. The therapeutic score remains relatively low because of the frequency of side effects and therapeutic escapes, even when an encouraging result has been obtained during the first years of treatment.
Topics: Adolescent; Adult; Aged; Arthritis, Juvenile; Arthritis, Rheumatoid; Child; Drug Tolerance; Female; Humans; Penicillamine; Pregnancy; Time Factors
PubMed: 3518031
DOI: No ID Found